When a couple find out they are expecting, a new chapter unfolds in their life, affecting them in every possible way – physically as well as spiritually. Sadly, that exciting journey does not always have a happy ending. In fact more and more women are experiencing pregnancies that end prematurely, sometimes halfway through. No reliable statistics are available for Egypt, but in Europe, for example, one in four women lose a baby during pregnancy or birth. “In various medical specialties, doctors deal with the pain and suffering of the patients,” says Dr Ahmed Guinena, obstetrician and former head of the gynecology department at Agouza Hospital, “but in this department we relish the fact that we deal with happiness, hope and aspiration, as after all that’s what having a baby is all about. Nevertheless, sometimes the story ends in grief when miscarriage occurs, and this is more common in early pregnancy; that’s why we advise women not to announce that they are expecting until the critical first 12 weeks have passed; after that the risk drops to one percent.” Following the first trimester, miscarriage before the 24th week is defined as “late miscarriage”. It happens when the mother goes into premature labour or the baby's heart stops beating. After this stage the definition of the loss is “stillbirth” – the baby is born with no heartbeat, or “neonatal death” – the baby has a heartbeat but dies shortly after birth. Dr Guinena stresses the fact that the reasons behind miscarriage are usually shrouded in mystery. Each case stands by itself; it may well defy the efforts of doctors to understand its implications. Still, some common causes or triggers can be pinpointed: Problems with the blood supply to the baby due to clotting in the mother. A random chromosomal abnormality in the baby. Defects leading to a weak cervix High blood pressure. Some illnesses like German Measles or having a high temperature. An abnormally shaped womb that lacks the space for the baby to grow in. “It is very important to understand that although every miscarriage will take its toll on a woman, the first miscarriage can usually be handled,” says Dr Heba Essawi, Professor of Psychiatry at the Medical School of Ain Shams University. “The problem tends to start when the incident is repeated; that is when uncertainty, anxiety, and eventually depression sink in. Bouts of anxiety have various apparent symptoms that may include palpitation, stomach pain or irrational fear, but we always try to handle the issue before such a psychological state leads to the body emitting antibodies preventing conception or to neurotransmitters destabilising the ovum, thus escalating the problem into a vicious circle.” Dr Essawi gives self-help guidelines for a woman experiencing such anguish: Reassurance is the word. Faith in God's help and the ever-improving capabilities of medicine should be continuously emphasised, and the fact that in most cases, a way out has been proven to exist. It is of the utmost importance for the woman to engage herself as soon as possible in her usual social routine and even go back to work. The pattern of life should be geared to managing stress, for instance jogging even for half an hour daily can be sufficient in inducing neurotransmissions that can act like anti depressants. A balanced and organised lifestyle is recommended in terms of adequate, continuous and stable sleeping intervals and regular meals. It is important to promote the body’s immune system through healthy food. Acceptance for the time being is a key factor: a woman who had been through such an experience should achieve a balance between acceptance and hope, and act naturally towards other children with love and care, neither carrying a burden of guilt nor feeling inferior.
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